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Prevalence and Associated Risk Factors of Cerebral Microbleeds in Egyptian Patients with Acute Ischemic Stroke and

Takwa H M Elkhatib1, Ahmed F Elsaid2, Rania M Al-Molla3

  • 1Department of Neurology, Zagazig University; Egypt.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|March 1, 2020
PubMed
Abstract

Insights

Cerebral microbleeds (CMB) prevalence was similar in Egyptian ischemic stroke patients with and without atrial fibrillation (AF). Key risk factors for CMB include older age, hypertension, anticoagulant use, and white matter lesions.

Area of Science:

  • Neurology
  • Radiology
  • Cardiology

Background:

  • Cerebral microbleeds (CMB) are increasingly recognized in stroke patients.
  • Limited data exists on CMB prevalence and risk factors in Egyptian patients with ischemic stroke and atrial fibrillation (AF).

Purpose of the Study:

  • To determine the prevalence of CMB in Egyptian ischemic stroke patients with AF.
  • To identify risk factors associated with CMB in this population.

Main Methods:

  • A case-control study involving 150 ischemic stroke patients with AF and 150 age/sex-matched controls without AF.
  • All participants underwent neurological examination and magnetic resonance imaging (MRI).
  • Risk factors for CMB were analyzed using univariate and multivariable logistic regression.

Main Results:

  • CMB prevalence was 40.7% in ischemic stroke patients with AF and 49.3% in those without AF.
  • Univariate analysis identified age, hypertension, diabetes, prior stroke, antiplatelet/anticoagulant use, NIHSS, CHA2DS2-VASc score, and WML as risk factors.
  • Independent risk factors for CMB were older age (OR 1.1), hypertension (OR 3.2), anticoagulant use (OR 3.3), and white matter lesions (WML) (OR 9.6).

Conclusions:

  • Atrial fibrillation (AF) was not associated with a higher prevalence of CMB in ischemic stroke patients.
  • Older age, hypertension, anticoagulant therapy, and WML are independent risk factors for CMB.
  • Elderly hypertensive AF stroke patients on anticoagulants require screening for CMB and monitoring for intracerebral hemorrhage.
Keywords:
AFIschemic strokeMRIanticoagulant therapycerebral microbleedsrisk factors

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